尽管对乙型肝炎进行了长期抗病毒治疗，但随着时间的推移

StephenW

Cancer Epidemiol Biomarkers Prev. 2020 Jan 27. pii: cebp.0614.2019. doi: 10.1158/1055-9965.EPI-19-0614. [Epub ahead of print]
Hepatocellular carcinoma risk steadily persists over time despite long-term antiviral therapy for hepatitis B: A multicenter study.
Kim SU1, Seo YS2, Lee HA2, Kim MN3, Lee EJ1, Shin HJ1, Lee YR4, Lee HW1, Park JY1, Kim DY1, Ahn SH1, Han KH1, Um SH5, Tak WY6, Kweon YO6, Kim BK7, Park SY6.
Author information

1
    Department of Internal Medicine, Yonsei University College of Medicine.
2
    Internal medicine, Korea University College of Medicine.
3
    CHA Bundang Medical Center.
4
    Kyungpook National University.
5
    Korea University College of Medicine.
6
    Department of Internal Medicine, Kyungpook National University.
7
    Department of Internal Medicine, Yonsei University College of Medicine [email protected].

Abstract
BACKGROUND:

Long-term antiviral therapy (AVT) for chronic hepatitis B (CHB) reduces the risk of hepatocellular carcinoma (HCC). We assessed the temporal trends in the incidence of HCC over time during long-term AVT among Asian CHB patients.
METHODS:

Patients with CHB receiving entecavir/tenofovir (ETV/TDF) as a first line antiviral were recruited from four academic hospitals in the Republic of Korea. We compared the incidence of HCC during and after the first 5 years of ETV/TDF treatment.
RESULTS:

Among 3,156 patients, the median age was 49.6 years and males predominated (62.4%). During the follow-up, 9.0% developed HCC. The annual incidence of HCC per 100 person-years during the first 5 years (n = 1,671) and after the first 5 years (n = 1,485) was statistically similar (1.93% vs. 2.27%, p = 0.347). When the study population was stratified according to HCC prediction model; i.e., modified PAGE-B score, the annual incidence of HCC was 0.11% vs. 0.39% in the low-risk group (<8 points), 1.26% vs. 1.82% in the intermediate-risk group (9-12 points), and 4.63% vs. 5.24% in the high-risk group (≥13 points) (all p>0.05). A Poisson regression analysis indicated that the duration of AVT did not significantly affect the overall trend of the incidence of HCC (adjusted annual incidence rate ratio 0.85 [95% confidence interval 0.66-1.11; p = 0.232]).
CONCLUSIONS:

Despite long-term AVT, the risk of HCC steadily persists over time among CHB patients in the Republic of Korea, in whom HBV genotype C2 predominates.
IMPACT:

Therefore, careful HCC surveillance is still essential.

Copyright ©2020, American Association for Cancer Research.

PMID:
    31988073
DOI:
    10.1158/1055-9965.EPI-19-0614

StephenW

癌症流行病生物标志物2020年1月27日。pii：cebp.0614.2019。 Doi：10.1158 / 1055-9965.EPI-19-0614。 [Epub提前发行]
尽管对乙型肝炎进行了长期抗病毒治疗，但随着时间的推移，肝细胞癌的风险仍会持续稳定：一项多中心研究。
Kim SU1，Seo YS2，Lee HA2，Kim MN3，Lee EJ1，Shin HJ1，Lee YR4，Lee HW1，Park JY1，Kim DY1，Ahn SH1，Han KH1，Um SH5，Tak WY6，Khonon YO6，Kim BK7，Park SY6 。
作者信息

1个
延世大学医学院内科。
2
高丽大学医学院内科。
3
CHA Bundang医疗中心。
4
庆北国立大学。
5
高丽大学医学院。
6
庆北国立大学内科。
7
延世大学医学院内科学系[email protected]。

抽象
背景：

慢性乙型肝炎（CHB）的长期抗病毒治疗（AVT）降低了肝细胞癌（HCC）的风险。我们评估了亚洲CHB患者长期AVT期间HCC发生率随时间变化的时间趋势。
方法：

从大韩民国的四家学术医院招募了接受恩替卡韦/替诺福韦（ETV / TDF）作为一线抗病毒药物的CHB患者。我们比较了ETV / TDF治疗的前5年和之后HCC的发生率。
结果：

在3156名患者中，中位年龄为49.6岁，男性为主要人群（62.4％）。在随访过程中，有9.0％的人患有肝癌。头5年（n = 1,671）和头5年（n = 1,485）之后每100人年的HCC年发生率在统计学上相似（1.93％对2.27％，p = 0.347）。根据HCC预测模型对研究人群进行分层时；即，修改后的PAGE-B评分，年肝癌的发生率为0.11％，而低危组为<0.38％（<8分），中危组为1.26％vs.1.82％（9-12分）高危组（≥13分）分别为4.63％和5.24％（所有p> 0.05）。 Poisson回归分析表明，AVT的持续时间并没有显着影响HCC发生的总体趋势（调整后的年发生率比率0.85 [95％置信区间0.66-1.11； p = 0.232））。
结论：

尽管长期进行AVT，但在韩国以CHV基因型C2为主的CHB患者中，随着时间的推移，HCC的风险持续稳定。
影响：

因此，仔细的HCC监视仍然必不可少。

美国癌症研究协会版权所有©2020。

PMID：
31988073
DOI：
10.1158 / 1055-9965.EPI-19-0614